Health Care Payments Remain Unaffordable for Millions in Europe
A new report from the World Health Organization reveals that financial hardship caused by out-of-pocket payments for medicines, medical products such as hearing aids, and dental care affects millions of people, even in Europe’s richest countries.
The report Can people afford to pay for health care? Evidence on financial protection in 40 countries in Europe highlights that out-of-pocket payments push between 1% and 12% of households into poverty or make them poorer.
Out-of-pocket payments lead to catastrophic health spending for between 1% and 20% of households on average. This rises to between 2% and 69% of households in the poorest fifth of the population. People who experience catastrophic health spending may not be able to pay for other basic needs such as food, housing and heating.
Catastrophic out-of-pocket payments are mainly driven by household spending on services that are commonly delivered or managed in primary-care settings, indicating important gaps in the coverage of primary care in many countries.
‘Our report shows that for millions of people in the WHO European Region, affordable access to health care is still a dream. Even before the pandemic, many people were facing an unacceptable level of catastrophic health spending,’ said Hans Henri P. Kluge, WHO Regional Director for Europe. ‘We need to transform our health systems now to ensure that people everywhere can receive the right care, at the right time, in the right place, from the right person – without experiencing financial hardship.’
Using new pre-pandemic data from 2019, the report finds that out-of-pocket payments for outpatient medicines lead to both financial hardship and unmet need for people with low incomes, preventing many from using health care. Out-of-pocket payments for dental care lead to financial hardship for richer households and unmet need for poorer households.
In addition to presenting a new analysis of financial hardship and unmet need for health care, the report highlights aspects of coverage policy – the way in which health coverage is designed and implemented – that undermine financial protection.
It notes that 5 common health coverage policy choices slow progress towards UHC because they disproportionately affect people with low incomes or chronic conditions, decrease efficiency in the use of health care, and weaken household and health system resilience to shocks.
To address this, the report proposes a checklist for policy-makers wanting to move closer to UHC. The checklist identifies 5 policy choices that have improved financial protection in countries with a low incidence of financial hardship and unmet need.